Testicular Cancer

Hormone treatment

Men who have lost one testicle due to cancer do not usually need testosterone replacement therapy, also called hormone replacement therapy (HRT). When one testicle has been surgically removed the other testicle produces extra hormones to compensate for what is lost.

However, in rare situations men are advised to have testosterone replacement (HRT). For example, sometimes the remaining testicle is shrunken and so not enough testosterone is produced, and so more testosterone is needed. Testosterone replacement may also be needed if a man is born with just one testicle, and later develops testicular cancer, or if a man has cancer in both testicles. 

HRT is recommended in these situations because if testosterone levels are low in later life there may be a decrease in bone mass (osteoporosis), decreased bone marrow activity leading to anaemia (a low blood count), muscle wasting, and a reduction in sexual drive and sperm production. A man's mood may also be affected.

HRT can be given by mouth, injected into a muscle, implanted as pellets under the skin of the lower abdomen, given via patches on the scrotum or elsewhere on the body, or as a gel. Each method has advantages and disadvantages, and the pros and cons should be discussed with the doctor.

Most men find that HRT is helpful and that it maintains a good quality sex life.

One man interviewed here, aged 39, who had fairly recently had cancer in both testicles, was taking hormone tablets three times a day. He was considering other options, but said that he liked the tablets. He recognised that he would not be able to have any more children, but said that the tablets keep his sex life going.

A young man, aged 26, born with only one testicle, was offered an HRT gel but didn't like the idea of rubbing it onto his body, and the possibility that he might rub it onto someone else by mistake. At the time of the interview he was having intramuscular injections, one every three weeks. He said that thanks to the HRT injections his sex life was 'great'. He was considering using a capsule, which would be injected under the skin, which would slowly release testosterone over a period of four months, which would be more convenient if he went travelling.

A man aged 50, who had lost both testicles, described how he felt before he had HRT. He had tried tablets, skin patches and implanted pellets, but had suffered unwanted side effects. He said that he could usually tolerate a drug called Virormoneâ, a form of HRT that he injected himself under the skin, and he said that HRT had changed his life in a spectacular manner. However, he developed polycythaemia (overproduction of red blood cells), a serious side effect of testosterone treatment (see 'Side effects of hormone treatment').

Occasionally, men who don't have any testicles can feel well without hormone treatment. One man interviewed was diagnosed in 1967, and he described his distress when HRT wasn't offered. In 1981, when he was offered HRT, he disliked the side effects, and stopped taking it in 1992 (see 'Side effects of hormone treatment'). When interviewed, aged 52, he said he was managing quite well without HRT.

Last reviewed March 2015.

Last updated March 2015.

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